Monday, February 11, 2008

A community pathologist asks "How can I survive?"

I am at a small community hospital and I feel like they do need a pathologist here. But my thought is that in order to support one, higher fees have to be charged. I do 3000 cases per year and take care of the lab. So I am diverse and busy but I am not a specialist. It makes the most sense to me that specialists like you should be reading all of my prostates and derm experts should be reading all my skins (etc). You are cheaper AND better at it. If I was a patient, that's what I would want. So how do I keep my job? The most efficient use of healthcare dollars would eliminate those of us at small places but we need to be here (I think). I am not trying to make a killing but I am trying to make a living. My hospital does do my billing but I have profit sharing and they listen to my input. The example of the 12 set biopsy is an extreme but I do know that ALL of my charges are high. So anyone without insurance is charged this. And insurance companies pay less. I didn't know that you were allowed to set up special fees for those who don't have insurance. I think we just wait for the patient to call and say they can't afford it, then we write some off.I just wonder if other small hospital pathologists have similar concerns about this.

1 comment:

J Oppenheimer said...

Overutilization of the number of biopsy cores and the immunohistochemical (IHC) stains that are applied to them is rampant. The lease on the automated immumnostainer must be paid off, and what about the cost of those antibodies that are going to expire. Better use them while one can eh?
And pathologists, or the employed lackeys of commercial firms, can increase their take-home pay by ordering as many IHC tests as they can make a rationalization for. When is the government going to wise up?